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APPLICATION FORM FOR OFFICIAL TEXAS HISTORICAL MARKER Texas Historical Commission State Marker Program P.O. Box 12276, Austin, Texas 78711
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Title of Marker County (subject to revision by Y THC staff) Marker Location . 09- 9 9 (street address and town,, nearest town on state highway map) Distance and direction If not on post, type of of subject su face to which marker from marker site will be attached wood, stone, etc.) Marker Site D of. Address City, Zip County Chairman -l 1, - 5 - 1/9 Person to whom marker U Addre City, Zip Telephone is to be shipped" 7 j' 5r l ,uu s (r uired) *If marker is to be placed on highway right-of.way, it will be shipped to your district highway engineer. Please consult the back of this page for specifications of the markers available. Check the items desired below. Approval of the application and narrative must be obtained from the county historical commission, as indicated by the county chairman's signature on this form, before forwarding the material to the Texas Historical Commission. Please do not send payment if ordering subject or building markers; funds will be requested once the application has been approved by the State Marker Committee. Sales tax must be added to the price, except if purchased by a tax-exempt organization. Applicants may order a marker with asocket to attach to their own post; however, the cost is the same as a marker furnished with a foundry post.
SUBJECT MARKERS O 16" x 12" grave marker (comes with mounting bar) ............... $225 a 27" x 42" subject marker with post .......................... $750 C 27" x 42" subject marker without post ........................... $700 o 18" x 28" subject marker with post ............. ........... $450 o 18" x 28" subject marker without post ........................... $400 * 1(We) request that RTHL designation be considered for this structure. (Please see signature line below.) BUILDING MARKERS o 16" x 12" building marker with post ......................... $350 O 16" x 12" building marker without post .......................... $300 Applications for building markers will automatically be considered for the RTHL designation. Please read carefully Texas Marker Policies 13 through 18, and indicate that you have done so signing below. Signatu of owner PAPERWEIGHTS Please indicate quantity desired. - 3" x 4" plastic paperweight mounted with replica of marker ...................................$90 Allow two months from completion of marker for receipt of paperweight Medallion paperweight ...................................... $40 Allows four lines of engraving please indicate desired wording.
DIRECTIONAL SIGNS Please indicate quantity desired and give location(s) on form above: 24" x 24" Historical Markers In City sign ............................. $80 These will be shipped to and placed on your town's city limits signs by the District Highway Engineer. Black and White (for farm-to-market roads, state and U.S. highways) Green and White (for interstate highways) 18" x 22" Historical Marker directional sign ..........................$80 In black and white only. For city and county roads Applicant must supply post and be responsible for placement - With arrow pointing straight ahead SWith arrow pointing left With arrow pointing right OTHER a National Register plaque ...................................... $ 50 Q 12" x 6" supplemental plate ................................... $110 D 16" x 12" building marker plate only (see policy #15) ...........................................$190 C Replacement medallion (see policy # 15) ....................... $110 D Bronze stars (for replacement on 1936 granite markers) ...........................................$ 25 C Bronze wreaths (for replacement on 1936 granite markers) ....................................... $ 25 C Bronze seals (for replacement on 1936 granite markers) ....................................... $ 65 C Bronze plates (for replacement on 1936 granite markers) ....................................... $185 [ Certificates of appreciation ................ .............. 50t each